Combination antibiotic therapy versus monotherapy for gram-negative bacteraemia: a commentary

Whether combination antimicrobial therapy is more efficacious than monother apy for gram-negative bacteraemia remains controversial. Although there are theoretical advantages to combination therapy that are buttressed by in vi tro and animal studies, the data from studies of patients with gram-negativ e bacteraemias have been conflicting. A review of selected clinical studies suggests that combination therapy is associated with improved outcome typi cally only in severely ill patients and its efficacy may be further limited to those with Pseudomonas aeruginosa, Klebsiella spp. or Enterobacter spp. bacteraemia. (C) 1999 Elsevier Science B.V. and International Society of C hemotherapy. All rights reserved.